Cochrane · systematic review · CD004667
Midwife continuity of care models versus other models of care for childbearing women
Sandall, J, Fernandez Turienzo, C, Devane, D, et al. · Cochrane Database of Systematic Reviews · 2024 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
26
current version
GRADE rated
19
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 7 · 26.9%Very low 8 · 30.8%Low 5 · 19.2%Moderate 6 · 23.1%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Show all 3 versionsSummary of findings table ‐ Midwife continuity of care models compared to other models of care for childbearing women and their infants (all) (critical outcomes)
Population: childbearing women and their infants (all) (critical outcomes)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Spontaneous vaginal birth (as defined by trial authors) Summary of findings table ‐ Midwife continuity of care models vs other models of care | RR 1.05 [1.03, 1.07] | 15 studies · 17864 participants | Moderate Downgraded: risk of bias |
Caesarean birth Summary of findings table ‐ Midwife continuity of care models vs other models of care | RR 0.91 [0.84, 0.99] | 16 studies · 18037 participants | Moderate Downgraded: risk of bias |
Regional analgesia (epidural/spinal) Summary of findings table ‐ Midwife continuity of care models vs other models of care | RR 0.85 [0.79, 0.92] | 15 studies · 17754 participants | Very low Downgraded: risk of bias, inconsistency, publication bias |
Intact perineum Summary of findings table ‐ Midwife continuity of care models vs other models of care | RR 1.05 [0.98, 1.12] | 12 studies · 14268 participants | Moderate Downgraded: risk of bias |
Fetal loss at or after 24 weeks gestation Summary of findings table ‐ Midwife continuity of care models vs other models of care | RR 1.24 [0.73, 2.13] | 12 studies · 16122 participants | Very low Downgraded: risk of bias, imprecision |
Preterm birth (< 37 weeks) Summary of findings table ‐ Midwife continuity of care models vs other models of care | RR 0.95 [0.78, 1.16] | 10 studies · 13850 participants | Low Downgraded: risk of bias, inconsistency |
Neonatal death (baby born alive at any gestation and dies within 28 days) Summary of findings table ‐ Midwife continuity of care models vs other models of care | RR 0.85 [0.43, 1.71] | 10 studies · 14718 participants | Very low Downgraded: risk of bias, imprecision |
Summary of findings table ‐ Midwife continuity models compared to other models of care for childbearing women and their infants (all) (important/secondary outcomes)
Population: childbearing women and their infants (all) (important/secondary outcomes)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Healthy mother Summary of findings table ‐ Midwife continuity models vs other models of care | no estimate extracted | 0 studies · 0 participants | Ungraded |
Maternal death Summary of findings table ‐ Midwife continuity models vs other models of care | no estimate extracted | 3 studies · 4282 participants | Ungraded |
Induction of labour Summary of findings table ‐ Midwife continuity models vs other models of care | RR 0.92 [0.85, 1] | 14 studies · 17666 participants | Low Downgraded: risk of bias, inconsistency |
Instrumental vaginal birth (forceps/vacuum) Summary of findings table ‐ Midwife continuity models vs other models of care | RR 0.89 [0.83, 0.96] | 14 studies · 17769 participants | Moderate Downgraded: risk of bias |
Episiotomy Summary of findings table ‐ Midwife continuity models vs other models of care | RR 0.83 [0.77, 0.91] | 15 studies · 17839 participants | Low Downgraded: risk of bias, inconsistency |
Third or fourth degree tear Summary of findings table ‐ Midwife continuity models vs other models of care | RR 1.1 [0.81, 1.49] | 7 studies · 9437 participants | Very low Downgraded: risk of bias, imprecision |
Postpartum haemorrhage (as defined by trial authors) Summary of findings table ‐ Midwife continuity models vs other models of care | RR 0.92 [0.82, 1.03] | 11 studies · 14407 participants | Moderate Downgraded: risk of bias |
Breastfeeding initiation Summary of findings table ‐ Midwife continuity models vs other models of care | RR 1.06 [1, 1.12] | 8 studies · 8575 participants | Low Downgraded: risk of bias, inconsistency |
Maternal readmission within 28 days Summary of findings table ‐ Midwife continuity models vs other models of care | RR 1.52 [0.78, 2.96] | 1 study · 1195 participants | Very low Downgraded: risk of bias, imprecision |
Neonatal readmission within 28 days Summary of findings table ‐ Midwife continuity models vs other models of care | no estimate extracted | 0 studies · 0 participants | Ungraded |
Attendance at birth by known midwife Summary of findings table ‐ Midwife continuity models vs other models of care | RR 9.13 [5.87, 14.21] | 11 studies · 9273 participants | Very low Downgraded: risk of bias, inconsistency, publication bias |
Healthy baby Summary of findings table ‐ Midwife continuity models vs other models of care | no estimate extracted | 0 studies · 0 participants | Ungraded |
Birth weight less than 2500 g Summary of findings table ‐ Midwife continuity models vs other models of care | RR 0.92 [0.79, 1.08] | 8 studies · 12420 participants | Low Downgraded: risk of bias, imprecision |
Birth weight equal to or more than 4000 g Summary of findings table ‐ Midwife continuity models vs other models of care | no estimate extracted | 0 studies · 0 participants | Ungraded |
Apgar score less than or equal to 7 at 5 minutes Summary of findings table ‐ Midwife continuity models vs other models of care | RR 0.95 [0.72, 1.24] | 13 studies · 12806 participants | Very low Downgraded: risk of bias, imprecision |
Admission to special care nursery/neonatal intensive care unit Summary of findings table ‐ Midwife continuity models vs other models of care | RR 0.89 [0.77, 1.03] | 13 studies · 16260 participants | Moderate Downgraded: risk of bias |
Fetal loss before 24 weeks gestation Summary of findings table ‐ Midwife continuity models vs other models of care | RR 0.82 [0.67, 1.01] | 12 studies · 15913 participants | Very low Downgraded: risk of bias, imprecision |
Maternal experience Summary of findings table ‐ Midwife continuity models vs other models of care | no estimate extracted | 16 studies · 16 participants | Ungraded |
Cost Summary of findings table ‐ Midwife continuity models vs other models of care | no estimate extracted | 7 studies · 7 participants | Ungraded |